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Please reply to the following discussion with one reference. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite resources in your responses to other classmates.
In gynecological care and history taken during an exam, it is important to include the 5 P’s including; partners, practices, prevention, protection and past. Partners include anyone the patient has been sexually active with including practices other than just penetration as well. Practices includes the different kinds of sex acts performed. Prevention includes anything done to prevent the spread of sexually transmitted diseases and pregnancy. Past allows the provider to understand the patient’s sexual history of STIs, abuse, use of drugs and more (Schuiling & Likis, 2020, p.452).
Most commonly seen with trichomoniasis are strawberry spots within the vaginal walls and on the cervix and have discharge that is green to cream colored. The discharge can be used to do a microscopic examination and identify if there is any trichomoniasis. Trichomoniasis will be one-celled flagellate. The wet mount will display a foul odor when potassium hydroxide is introduced and an increased number of white blood cells (Schuiling & Likis, 2020, p.452).
Diagnosis is trichomoniasis and the three differential diagnoses that would be included are cervicitis, vaginitis and urinary tract infection. Vaginal discharge would present with cervicitis and vaginitis, pelvic pain is seen in all three and unprotected sex can cause any of these diagnosis (Schuiling & Likis, 2020, p.452).
Management for this patient would include antibiotic treatment with nitroimidazoles, “metronidazole 2 gm orally in a single dose or tinidazole 2 gm orally in a single dose” (Schuiling & Likis, 2020, p.452). During the antibiotic use, the patient should remain abstinent and avoid alcohol. She should return for a recheck once the antibiotic has been completed to make sure the infection is gone (Schuiling & Likis, 2020).
Schuiling, K. D. & Likis, F. E. (2020). Gynecologic health care (4th ed.). Jones & Bartlett. ISBN: 9781284182347
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